FMCCC Online Pre-registration

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Florida Mopar Nationals Pre-registration Form

Please select Registration type: Participant $25 Vendor/Swap Meet (10x20) $25

LIABILITY. In consideration of the acceptance of the right to participate, entrants and spectators, by the execution of this form, release and discharge the sponsoring clubs, officers, directors, employees, agents and representatives and anyone else connected with the management or presentation of the car show and swap meet of and from any course whatsoever that may be suffered by an entrant to their person or property. Further each entrant/vendor expressly agrees to indemnify all forgoing entities, firms, persons and bodies of and from any and all liability occasioned or resulting from the conduct of entrants/spectators or any participant assisting or cooperating with entrant and under the direction of control of entrant. We reserve the right to restrict inappropriate, offensive or copyrighted merchandise. RAIN OR SHINE!

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First Name	Last Name
Work Phone	Phone
Email	Preferred Contact Email Phone
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Vehicle Information
Year	Make
Model	Exterior Colour
VIN	Kilometres
Engine	Doors
Transmission	Drivetrain

Vehicle Rating
Body (dents, dings, rust, rot, damage)	Tires (tread wear, mismatched)
Engine (running condition, burns oil, knocking)	Transmission / Clutch (slipping, hard shift, grinds)
Glass (chips, scratches, cracks, pitted)	Interior (rips, tears, burns, faded/worn, stains)
Exhaust (rusted, leaking, noisy)

Vehicle History

Was it ever a lease or rental return?

Is the odometer operational and accurate?

Detailed service records available?

Title History

Is there a lienholder?

Who holds this title?

Vehicle Assessment
Does all equipment and accessories work correctly?	Did you buy the vehicle new?
Has the vehicle ever been in any accidents? Cost of repairs?	Is there existing damage on the vehicle? Where?
Has the vehicle ever had paint work performed?	Is the title designated 'Salvage' or 'Reconstructed'? Any other?

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Phone:
Offered Price:
Financing Required:
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Best Day:
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Florida Mopar Nationals Pre-registration Form

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Vehicle History

Title History

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